Test 1: lecture 4: fertility problems Flashcards
differentials
small ovaries/ streak ovaries
- hypoplasia- 63 XO karyotype
- anestrus?
- atrophied ovaries
how to diagnose 63 XO karyotype?
small ovaries
- Repeated palpations reveal no ovarian activity since estimated time of puberty.
- Ovaries are very small, smooth and firm. “streak ovaries”
- Extensive follicular atresia at birth
- Uterus and cervix are usually small and flaccid due to a lack of ovarian hormones.
- The mare is smaller in stature than expected.
- Definitive diagnosis by karyotype reveals only one X chromosome
ca a 63 XO mare have a foal
yes, if you transfer an embryo and give progestogen throughout gestation.
* they don’t have their own eggs and their repro tract is small
— most common ovarian tumor in mare.
Granulosa Cell Tumor (GCT)
- enlarged ovaries
- hard
- no ovulation fossa palpation
- abnormal hormones- ↑ testosterone, inhibin, AMH
- othere ovary will be small from ↑ inhibin
- behavior changes: anestrus, nymphomania, heterotypic/stallion like behavior
how to treat Granulosa Cell Tumor (GCT)
ovariectomy of GCT; may take up to 1.5 years for opposite ovary to regain function
- hard tumor, can’t feel ovulation fossa, behavior changes: anestrus, nymphomania, stallion-like behavior
Granulosa Cell Tumor (GCT) are multicystic
- no obvious ovulation fossa
behavior changes from GCT
Anestrus- These mares do not have an estrus cycle because the follicles will not mature and ovulate due to the high concentrations of inhibin. lack steroids
Nyphomania- These mares do NOT have elevated concentrations of estrogens. But if they are housed in proximity to stallions or amorous geldings they will not resist/reject the stallions advances because they have no progesterone. So they may appear to be in heat every day but in fact they really are not cycling.- lack steroids
Heterotypic behavior is behavior of the opposite sex. So male/stallion type behavior in a mare. ↑ androgens
what happens to other ovary with GCT
one big
one little from ↑ inhibin
test for GCT
blood test measuring hormone concentrations
* 48% have elevated testosterone
* 80% have elevated inhibin
* 98% have elevated anti Mullerian hormone
* Progesterone concentrations are usually < 1 ng/ml as most mares do not cycle and ovulate. Therefore the mare has no CL. We have seen a few pregnant mares with a GCT.
Histological section of a cystic space of a GCT. The diagnosis is made by the presence of piles of layers of granulosa cells lining irregularly shaped cystic spaces.
mare ovary, other ovary normal
Cystadenoma or Cystadenocarcinoma
— are rare but are often confused with a GCT. One should always have histology performed on any mass that is removed from the ovary.
Cystadenomas
— are germ cell tumors.
Teratoma
Neoplastic cells are pluripotent and can form many different cell types.
hematoma- will eventually regress on its own, does not effect cycling
* can still feel ovulation fossa
Epoophoron cyst will always be present on the ovary. Cystic remnant of the mesonephric tubules. Is not thought to cause problems. Just don’t confuse with a breed-able follicle.
— will always be present on the ovary. Cystic remnant of the mesonephric tubules.
Epoophoron cyst
- Is not thought to cause problems. Just don’t confuse with a breed-able follicle.
differentials for large ovaries
- GCT- other ovary small, behavior changes
- Cystadenoma
- teratoma
- hematoma- resolves on its own
- Epoophoron cyst- always there but its fine- old mesonephric tubules
- transitional ovaries- normal for the season
Patency of the oviducts is evaluated by
direct flushing of the oviduct or by placing starch grains, fluorescent beads, radioactive spheres on the surface of the ovary and examining for evidence of marker particles in uterine lavage effluent.
an accumulation of fluid in the oviduct due to an occlusion of the ends of the oviduct (may be congenital or acquired).
hydrosalpinx
how to treat hydrosalpinx if unilateral
if unilateral, surgical removal of
oviduct and ipsilateral/same side ovary.
Sonogram of the convoluted, anechoic fluid distended oviduct.
- hydrosalpinx
Parovarian cyst - cystic remnants of the mesonephric ducts; not pathologic. May be mistaken for a follicle during ultrasound examination.
* no treatment required
Germinal inclusion cysts or “fossa-cysts” are formed by peritoneal fragments that become imbedded in the ovary following ovulation. These “serosal” cysts may be large enough or numerous enough to be of clinical significance by possibly interfering with ovum transport in older mares.“
infundibulum
Fimbria cysts (Hydatid of Morgagni)
- only remove if too big, hemorrhage, adhesions
blocked oviduct- how to treat?
blocked oviduct- accumulation of type 1 collagen fibers
- PGE2 (endoscopic, directyly on duct) will cause isthmus to expel the globular mass- $$$
- misopostol (PGE1) intrauterine application
mare uterus
endometritis
- filled with hyperechoic fluid
- uterine horn distended
endometrium
endometritis: Severe granuloma evidenced by the large foci of lymphocytes and plasma cells in this endometrium.
wall of uterus
Periglandular fibrosis is severe and there is severe nesting of glands and severe cystic glandular distension associated with the fibrosis. This would be Category III-5 endometrium that would have difficulty carrying a foal to term.
why would horse not get pregnant
endometrial cyst
- embryo needs to touch all the walls of uterus, this would get in the way and cause lutinization and loss of pregnancy
Pyometra - accumulation of pus in the uterus
what type of tumor
Leiomyoma- uterine tumors are not common
